Who pays for care at non-VA hospitals?

adminJan 22nd, 2018Comments Off on Who pays for care at non-VA hospitals?

#Middlebury #VeteransPost

If you have a medical emergency, the first thing on your mind is getting care fast. If that means going to a non-Department of Veterans Affairs hospital, so be it. It’s afterward, when the bills come due, that problems arise, especially if no one thought to call the VA to get permission for care at a non-VA facility.

A lawsuit by a veteran has resulted in a big change in the rules. The veteran suffered a heart attack and strokes. He obviously needed quick treatment somewhere, and he got it. He was in no shape to think about calling the VA. He was hospitalized for a long time. Afterward, the hospital wanted a pile of cash from the veteran when his other insurance left a lot unpaid.

Until now, the VA was let off the hook for any non-VA medical facility costs if the veteran had any third-party insurance, including an auto insurance policy that provided even a tiny amount of coverage for medical care after a wreck. That loophole left the veteran liable for the whole unpaid balance at the non-VA hospital.

With the new rule, if a veteran has an emergency and has third-party insurance that pays part of the bill, the VA has to pony up a certain amount, based on whether the emergency had to do with service-connected versus non-service-connected conditions. That amount also will be determined by the type of insurance, including Medicare. The veteran won’t be let off the hook completely when it comes to deductibles, co-pays, etc.

If you’re being hounded for payment by a non-VA hospital, tell them about the new regulation and that the VA likely will have to be second payer. They’ll know what that means. If you have questions, there is a dedicated hotline: 1-877-466-7124.